Quality Care Improvement Specialist — HEDIS & CMS

Astrana Health; California (MO); Hybrid; USD 31,684 - 45,460; Full time

Job summary

A healthcare organization is seeking a QCI Specialist to enhance quality care across its network. This role focuses on improving health plan metrics and collaborating with various healthcare providers. The ideal candidate will possess a Bachelor's degree and have 3–5 years of healthcare experience, including HEDIS expertise. Strong analytical and communication skills are essential, as well as the ability to travel up to 25% in Southern California. This position offers a hybrid work model with competitive hourly compensation.

Qualifications

• 3–5 years of experience in healthcare, ideally in IPA/MSO/Health Plan environments.
• Minimum of 1 year of HEDIS-related experience.
• Independent transportation and ability to travel up to 25% as needed.

Responsibilities

• Serve as a quality performance resource to assigned health plan partners.
• Collaborate with assigned health plans and/or provider offices.
• Analyze provider performance data, identify trends, and deliver targeted education.

Skills

Analytical skills

Communication skills

Presentation skills

Knowledge of managed care

Collaboration

Education

Bachelor’s degree or equivalent experience

Job description

A healthcare organization is seeking a QCI Specialist to enhance quality care across its network. This role focuses on improving health plan metrics and collaborating with various healthcare providers. The ideal candidate will possess a Bachelor's degree and have 3–5 years of healthcare experience, including HEDIS expertise. Strong analytical and communication skills are essential, as well as the ability to travel up to 25% in Southern California. This position offers a hybrid work model with competitive hourly compensation.